International patient travel consideration post radio receptor therapy - US experience

PRRT has been used for the treatment of advanced somatostatin receptor positive gastroenteropancreatic neuroendocrine tumors. Most commonly used forms of PRRT are Lutetium177 labeled DOTATATE (Lutathera, Advanced Accelerator Applications, a Novartis company) which was recently approved by U.S. Food and Drug Administration (FDA) and Yttrium 90 labeled DOTATATE. In our experience, it is not uncommon for patients recently treated with PRRT to be stopped by United States Customs and Border Protection (CBP) officers while traveling, due to the detection of residual radiation activity. We would like to present results of an online public survey about patient experience with travel after PRRT. An online public survey performed by one of our authors (JAM) regarding patient experience at the US ports of entry and high security areas after PRRT. 54 episodes of treatment-related travel delays reported in the survey. Time from radiation detection to final security clearance was less than 30 min in 17% of cases (9 events), 30-60 min - in 22% (12 events), 1-2 hrs - in 37% (20 events), more than 2 hrs - in 24% (13 events). Majority of patients (44 pts, or 81%) reported being treated with Lu177, 15% (8 pts) - with Y90, 4% (2 pts) - with combination of Lu177 and Y90. Traveling while undergoing PRRT should be discussed with the patient by the clinical care team and nuclear medicine/nuclear radiology team prior to treatment to avoid any unwanted surprises. Patients can arrange their schedules accordingly if they are well informed about this process ahead of time. (author)